Evaluating the Usefulness of the Blood Apolipoprotein A2 Isoform Index for Pancreatic Cancer Diagnosis
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Outcomes and Definitions
2.3. Statistical Analyses
3. Results
3.1. Patient Characteristics
3.2. Diagnostic Performance of APOA2-i Index
3.3. Diagnostic Performance of CA 19-9
3.4. Diagnostic Performance of Combination of APOA2-i Index with CA 19-9
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
APOA2 | Apolipoprotein A2 |
CA 19-9 | Carbohydrate antigen 19-9 |
APOA2-i | Apolipoprotein A2-isoform |
PPV | Positive predictive value |
NPV | Negative predictive value |
OR | Odds ratio |
PC | Pancreatic cancer |
CI | Confidence interval |
ROC | Receiver operating characteristic |
EUS | Endoscopic ultrasound |
IPMN | Intraductal papillary mucinous neoplasm |
CP | Chronic pancreatitis |
AUC | Area under the curve |
CT | Computed tomography |
MPD | Main pancreatic duct |
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Age (Year) | Median (Year) [Range] | 70.5 [25–94] |
---|---|---|
Sex | Male | 99 |
Female | 75 | |
Diseases | PC | 76 |
Intraductal papillary mucinous neoplasm | 36 | |
Chronic pancreatitis | 33 | |
Auto immune pancreatitis | 9 | |
Pancreatic neuroendocrine neoplasm | 8 | |
Others | 12 | |
PC stages | Stage 0 | 5 |
Stage I | 4 | |
Stage II | 15 | |
Stage III | 19 | |
Stage IV | 33 | |
Biomarker | ApoA2-I Index positive | 58 |
CA 19-9 positive | 69 | |
Either positive | 92 |
ApoA2-i Index | CA 19-9 | Either Positive | ||
---|---|---|---|---|
Overall results | 33.3% (58/174) | 33.3% (58/174) | 39.7% (69/174) | 52.9% (92/174) |
Age | 65 year > | 28.8% (19/66) | 34.8% (23/66) | 51.5% (34/66) |
65 year ≦ | 36.1% (39/108) | 39.8% (43/108) | 53.7% (58/108) | |
p-value | 0.32 | 0.96 | 0.78 | |
Sex | Male | 37.4% (37/99) | 35.4% (35/99) | 49.5% (49/99) |
Female | 28% (21/75) | 45.3% (34/75) | 60% (45/75) | |
p-value | 0.18 | 0.20 | 0.31 | |
PC | PC cases | 48.7% (37/76) | 76.3% (58/76) | 84.2% (64/76) |
non PC cases | 21.4% (21/98) | 11.2% (11/98) | 28.6% (28/98) | |
p-value | <0.001 | <0.001 | <0.001 | |
CP | CP cases | 24.2% (8/33) | 12.1% (4/33) | 30.3% (10/33) |
non CP cases | 35.5% (50/141) | 46.1% (65/141) | 58.2% (82/141) | |
p-value | 0.22 | <0.001 | 0.004 | |
PC stage | Stage 0 or I | 33.3% (3/9) | 22.2% (2/9) | 44.4% (4/9) |
Others | 33.3% (55/165) | 40.6% (67/165) | 53.3% (88/165) | |
p-value | N/A | 0.27 | 0.60 | |
Stage II to IV | 50.7% (34/67) | 83.6% (56/67) | 89.6% (60/67) | |
Others | 22.4% (24/107) | 12.1% (13/107) | 29.9% (32/107) | |
p-value | <0.001 | <0.001 | <0.001 |
Sensitivity | Specificity | PPV | NPV | ||
---|---|---|---|---|---|
ApoA2-i Index | PC | 48.7% (37/76) | 78.6% (77/98) | 63.8% (37/58) | 66.4% (77/116) |
Stage 0 or I | 33.3% (3/9) | 66.7% (110/165) | 5.2% (3/58) | 94.8% (110/116) | |
Stage II to IV | 50.7% (34/67) | 77.6% (83/107) | 58.6% (34/58) | 71.6% (83/116) | |
CA 19-9 | PC | 76.3% (58/76) | 88.8% (87/98) | 84.1% (58/69) | 82.9% (87/105) |
Stage 0 or I | 22.2% (2/9) | 59.4% (98/165) | 2.9% (2/69) | 93.3% (98/105) | |
Stage II to IV | 83.6% (56/67) | 87.9% (94/107) | 81.2% (56/69) | 89.5% (94/105) | |
Either positive | PC | 84.2% (62/76) | 71.4% (70/98) | 69.6% (64/92) | 85.4% (70/82) |
Stage 0 or I | 44.4% (4/9) | 46.7% (77/165) | 4.3% (4/92) | 93.9% (77/82) | |
Stage II to IV | 89.6% (60/67) | 70.1% (75/107) | 65.2% (60/92) | 91.5% (75/82) |
Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|
ApoA2-i Index | p-Value | OR | 95% CI | p-Value |
PC cases | <0.001 | 3.48 | 1.80–6.73 | <0.001 |
Age | 0.50 | |||
Sex | 0.17 | |||
CP cases | 0.44 | |||
CA 19-9 | ||||
PC cases | <0.001 | 25.5 | 11.2–57.9 | <0.001 |
Age | 0.33 | |||
Sex | 0.088 | |||
CP cases | 0.84 | |||
Either positive | ||||
PC cases | <0.001 | 13.3 | 6.26–28.4 | <0.001 |
Age | 0.64 | |||
Sex | 0.24 | |||
CP cases | 0.79 |
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Shionoya, K.; Sofuni, A.; Mukai, S.; Tsuchiya, T.; Tanaka, R.; Tonozuka, R.; Yamamoto, K.; Nagai, K.; Matsunami, Y.; Kojima, H.; et al. Evaluating the Usefulness of the Blood Apolipoprotein A2 Isoform Index for Pancreatic Cancer Diagnosis. Cancers 2025, 17, 1071. https://doi.org/10.3390/cancers17071071
Shionoya K, Sofuni A, Mukai S, Tsuchiya T, Tanaka R, Tonozuka R, Yamamoto K, Nagai K, Matsunami Y, Kojima H, et al. Evaluating the Usefulness of the Blood Apolipoprotein A2 Isoform Index for Pancreatic Cancer Diagnosis. Cancers. 2025; 17(7):1071. https://doi.org/10.3390/cancers17071071
Chicago/Turabian StyleShionoya, Kento, Atsushi Sofuni, Shuntaro Mukai, Takayoshi Tsuchiya, Reina Tanaka, Ryosuke Tonozuka, Kenjiro Yamamoto, Kazumasa Nagai, Yukitoshi Matsunami, Hiroyuki Kojima, and et al. 2025. "Evaluating the Usefulness of the Blood Apolipoprotein A2 Isoform Index for Pancreatic Cancer Diagnosis" Cancers 17, no. 7: 1071. https://doi.org/10.3390/cancers17071071
APA StyleShionoya, K., Sofuni, A., Mukai, S., Tsuchiya, T., Tanaka, R., Tonozuka, R., Yamamoto, K., Nagai, K., Matsunami, Y., Kojima, H., Minami, H., Hirakawa, N., Asano, K., Yamaguchi, Y., Hama, K., & Itoi, T. (2025). Evaluating the Usefulness of the Blood Apolipoprotein A2 Isoform Index for Pancreatic Cancer Diagnosis. Cancers, 17(7), 1071. https://doi.org/10.3390/cancers17071071